Afghanistan: civilians facing hardship on all sides

In many parts of the country, extreme poverty, the risk of being injured or killed by improvised explosive devices, or of being stopped at checkpoints makes it extremely difficult for many Afghans to obtain health care, as do attacks on hospitals and intimidation of health staff.

"Providing help where it is needed, as close as possible to the victims of the conflict, and in a way that is neutral, impartial and independent, must be the driving force behind humanitarian endeavour," said Pierre Krähenbühl, the ICRC's director of operations. "It is ever more needed in Afghanistan, and increasingly difficult to achieve in such an unstable environment."

Visiting places of detention and restoring family links

The ICRC is mandated to monitor the conditions and treatment of detainees in places of detention worldwide. In Afghanistan, ICRC delegates regularly visit prisons run by nations contributing to the NATO-led International Security Assistance Force (ISAF), by US forces and by the Afghan authorities. The ICRC also helps family members separated by conflict to stay in touch with one another, and endeavours to trace missing persons.

During May and June, ICRC staff:

• carried out 38 visits to 36 places of detention;
• monitored the cases of 661 detainees, visiting 479 of them for the first time;
• paid the transport costs for four ex-detainees to return to their home villages;
• collected 914 Red Cross messages and distributed 1,525, mostly between detainees and their families, with the help of the Afghan Red Crescent;
• facilitated 850 video telephone calls between families and their relatives held in the US-run Parwan detention facility at Bagram airfield;
• provided transportation to enable the families of 164 detainees held in the Parwan facility to visit their loved ones in person.

Providing health care

The ICRC provides medicines and medical support to Sheberghan Hospital in the north and Mirwais Regional Hospital in the south, both of which are run by the Ministry of Public Health. Over 20 expatriate doctors, nurses and administrative personnel are supporting the staff at Mirwais. The ICRC also provides technical and financial support and medicines to 46 Afghan Red Crescent clinics, and to community-based first-aid volunteers who deliver health care to people in conflict-affected areas. The organization delivers drugs and non-medical items to three health clinics in the south and east once a month. In addition, the ICRC runs four first-aid posts, one in the west and three in the south. During May and June, Mirwais and Sheberghan Hospitals admitted almost 9,000 inpatients and held nearly 39,000 outpatient consultations between them. More than 1,680 surgical operations were performed in the two hospitals.

In addition, during the same period, the ICRC:

• distributed kits to the front lines to treat people injured in the fighting;
• provided first-aid training for 360 combatants, doctors, police and community-based first-aid volunteers.

Providing limb-fitting and physical rehabilitation services

In Afghanistan, the ICRC runs seven prosthetic/orthotic centres which provide rehabilitation services for amputees and others with disabilities. The centres support the social reintegration of disabled people, ranging from landmine victims to those with spinal cord injuries. They also run a home-care service offering medical, economic and social support for patients with spinal cord impairments. The ICRC has been providing these services in Afghanistan for over 20 years.

During May and June, the seven ICRC centres:

• registered nearly 1,400 new patients, including 227 amputees;
• assisted 13,645 patients;
• fitted over 2,660 prostheses and orthotic devices;
• held almost 37,250 physiotherapy sessions;
• granted micro-credit loans to approximately 160 patients to help them start small business ventures;
• provided vocational training for 213 patients, 42 of whom completed their training during this period;
• conducted 1,180 home visits to patients with spinal cord injuries.

Distributing food and other aid

Distributing food and other items to families displaced by conflict or natural disaster remains one of the ICRC’s major activities in Afghanistan. This service comprises emergency food distribution, "food for work" projects, and support for agriculture and livestock programmes. The ICRC provides aid to displaced communities in close cooperation with the Afghan Red Crescent Society.

During May and June, the ICRC:

• distributed nearly 345 metric tonnes of food to over 3,100 participants in food-for-work projects;
• worked together with the Afghan Red Crescent to distribute one-month food rations and essential household items to over 3,800 families displaced by the conflict or natural disaster in all parts of the country;
• built poultry shelters and started the installation of hatchery units in 12 communities in the north, which will benefit 220 families, and provided them with incubators, feeding equipment, and eggs for hatching purposes. This project is conducted by women to help them earn a living and support their families;
• trained 320 farmers in livestock management and animal husbandry.

Improving water and sanitation services

ICRC water engineers are working closely with local water boards on urban and rural projects. The organization promotes hygiene awareness in religious schools and detention centres, and with families in their homes.

During May and June, the ICRC:

• worked on urban projects that will supply water for over 193,250 people in Kabul, Jalalabad, Laghman, Trinkot, Kandahar, Mazar-i-Sharif and Kunduz;
• worked on rural projects that will provide safe water for almost 53,000 people in Kabul, Bamyan, Herat, Jalalabad, Lashkar Gah, and Kunduz provinces;
• carried out hygiene-promotion sessions for some 21,300 people in Kabul, Herat, Farah, Laghman, Jalalabad, Kandahar and Balkh (Mazar);
• continued to improve the water supply and sanitary conditions for nearly 4,400 detainees in eight provincial prisons;
• continued renovation work at Mirwais Hospital in Kandahar.

Promoting compliance with international humanitarian law

Reminding parties to a conflict of their obligation to protect civilians is a fundamental part of the ICRC's efforts to promote compliance with international humanitarian law worldwide. The organization also spreads knowledge of international humanitarian law within civil society, government bodies and the armed forces.

During May and June, ICRC staff:

• gave presentations on international humanitarian law for over 720 people;
• held two three-day training courses on international humanitarian law for 65 members of the Afghan national police, the national army and the National Directorate of Security;
• held briefings for community elders, members of religious circles, aid recipients and members of the Afghan Red Crescent that were attended by over 1,140 people in all.

Working in partnership with the Afghan Red Crescent Society

The ICRC provides the Afghan Red Crescent Society with technical and financial assistance to help it deliver services to the community and to implement a range of programmes.

During May and June:

• Afghan Red Crescent volunteers regularly helped distribute food and other items;
• dozens of community-based first-aid volunteers received training.

Afghanistan is the ICRC's biggest operation in terms of resources committed. The organization has nearly 1,600 national staff and 142 expatriates based in its main delegation in Kabul and in five sub-delegations and 10 offices countrywide. In addition, it operates seven physical rehabilitation centres.

For further information, please contact:
Jessica Barry, ICRC Kabul, tel: +93 700 282 719
Abdul Hassib Rahimi (Dari and Pashto), ICRC Kabul, tel: +93 700 276 465
Christian Cardon, ICRC Geneva, tel: +41 22 730 24 26 or +41 79 251 93 02